Ultrasonik cerrahi debridman sistemleri: İnatçı diyabetik ayak ülserleri için güncel bir tedavi yöntemi

Öz

Chronic wounds remain one of the most challenging problems facing healthcare professionals with their ever-increasing impact on various domains of healthcare and well-being . Numerous management modalities have been proposed to reduce the clinical burden and healthcare costs associated with chronic wounds . Given the pivotal role debridement plays in wound care, it became a focus of interest for new therapeutic strategies in recent years . Herein, we report our experience with the SyllableTM Ultrasonic Surgical Debridement System manufactured by Mavera Medical Devices Inc. in a patient presenting with recalcitrant grade 3 stage D diabetic foot ulcers by the UT (University of Texas) system.

Anahtar Kelimeler

• ultrasonic debridement
• bioburden
• diabetic foot ulcer
• biofilm

Ultrasonic-assisted wound debridement: An emerging treatment modality for recalcitrant diabetic foot ulcers

Öz

Kronik yaralar, giderek artmakta olan etkileriyle sağlık profesyonellerinin karşılaştığı en zorlu sorunlardan biri olmaya devam etmektedir. Kronik yaralarla ilişkili klinik yükü ve sağlık maliyetlerini azaltmak için birçok modalite önerilmiştir. Debridman, yara bakımında oynadığı kritik rol nedeniyle son yıllarda yeni terapötik stratejiler için ilgi odağı haline gelmiştir. Bu vaka raporunda, geleneksel tedaviye dirençli, UT sistemine göre grade 3 stage D diyabetik ayak ülseri ile başvuran bir hasta üzerinde kullanılan SyllableTM Ultrasonik Cerrahi Debridman Sistemi ile olan deneyimimizi sunuyoruz.

Anahtar Kelimeler

• ultrasonik debridman
• biyoyük
• diyabetik ayak ülseri
• biyofilm

Kaynakça

1. Crone S, Garde C, Bjarnsholt T, Alhede M. A novel in vitro wound biofilm model used to evaluate low-frequency ultrasonic- assisted wound debridement. J Wound Care. 2015;24(2):64-72. doi:10.12968/jowc.2015.24.2.64
2. Madhok BM, Vowden K, Vowden P. New techniques for wound debridement. Int Wound J. 2013;10(3):247-251. doi:10.1111/ iwj.12045
3. Shojaiefard A, Khorgami Z, Larijani B. Independent risk factors for amputation in diabetic foot. Int J Diabetes Dev Ctries. 2008;28(2):32-37. doi:10.4103/0973-3930.43096
4. Solovyev, D.A., Shchukin, S.I., Skvortsov, S.P. et al. Ultrasound Treatment of Infected Wounds: Situation and Perspectives. Biomed Eng 52, 396–401 (2019). https://doi.org/10.1007/ s10527-019-09855-7
5. Lepäntalo M, Apelqvist J, Setacci C, et al. Chapter V: Diabetic foot. Eur J Vasc Endovasc Surg. 2011;42 Suppl 2:S60-S74. doi:10.1016/ S1078-5884(11)60012-9
6. Herberger K, Franzke N, Blome C, Kirsten N, Augustin M. Efficacy, tolerability and patient benefit of ultrasound- assisted wound treatment versus surgical debridement: a randomized clinical study. Dermatology. 2011;222(3):244-249. doi:10.1159/000326116
7. Graves N, Ganesan G, Tan KB, et al. Chronic wounds in a multiethnic Asian population: a cost of illness study. BMJ Open. 2023;13(9):e065692. doi:10.1136/bmjopen-2022-065692
8. Ingelfinger JR, Jarcho JA. Increase in the Incidence of Diabetes and Its Implications. N Engl J Med. 2017;376(15):1473-1474. doi:10.1056/NEJMe1616575

9. Lázaro-Martínez JL, Álvaro-Afonso FJ, Sevillano-Fernández D, García-Álvarez Y, Sanz-Corbalan I, García-Morales E. Cellular Proliferation, Dermal Repair, and Microbiological Effectiveness of Ultrasound-Assisted Wound Debridement (UAW ) Versus Standard Wound Treatment in Complicated Diabetic Foot Ulcers (DFU): An Open-Label Randomized Controlled Trial. J Clin Med. 2020;9(12):4032. Published 2020 Dec 13. doi:10.3390/jcm9124032